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NPI Code Detail

MEDICARE: SANSUM CLINIC

MEDICARE: SANSUM CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1932121514
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANSUM CLINIC
Provider Business Mailing Address
First Line : PO BOX 62106
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93160-2106
Country : US
Telephone Number : 805-681-7768
Fax Number :
Provider Business Practice Location Address
First Line : 317 W PUEBLO ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-4355
Country : US
Telephone Number : 805-681-1768
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : CHAD HINE
Credential :
Telephone Number : 805-681-1702
Provider Enumeration Date : 07/24/2006
Last Update Date : 06/27/2012

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Directions to “SANSUM CLINIC ” Practice Location

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